Dwic Of Tampa Bay, INC
Clinic/Center, Urgent Care in Deland, FL. Organization (NPI-2).
NPI number1124568902
StatusActive
Last updated in NPPESMay 7, 2024
Details
- NPI
- 1124568902
- Entity type
- Organization (NPI-2)
- Legal business name
- Dwic Of Tampa Bay, INC
- Organization subpart
- No
- Enumeration date
- Feb 28, 2017
- Certification date
- May 7, 2024
- Last updated
- May 7, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QU0200X | Clinic/Center, Urgent Care | – | – | Yes |
| 208D00000X | General Practice | – | – |
Other names
- Medexpress Urgent Care - Deland, N Woodland Blvd (Doing Business As)
Practice location
1328 N Woodland BlvdDeland, FL 32720-2203
Phone 386-738-0574 · Fax 386-738-0573
Mailing address
423 Fortress BlvdMorgantown, WV 26508-1351
Phone 304-225-2500 · Fax 304-985-6350
Authorized official
Joy Kimball
Contract Manager
7633496740
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